A case management intervention targeted to reduce healthcare consumption for frequent Emergency Department visitors: results from an adaptive randomized trial.
Source: Edgren, G., et al. 2016 - Pubmed ID: 25969342
Setting: Sweden, Hospitals from 3 counties
RCT
Follow up:
- Until Death or
- Until End of study (march 2014) or
- Maximum two years
Sample size:
Total: 12181 (8536)
IG: 8214 (4569)
CG: 3967 (3967)
Inclusion criteria:
- 3 or more emergency visits during previous 6 months.
Phone call
- Coaching disease self-management
- Support interaction with social services
- Facilitated contacts with healthcare providers.
Intervention: Patient and nurse meet for interview of patient’s medical and social history. This information was used to guide the intervention. Telephone contact was made on a regular basis. Nurses facilitated contacts with healthcare providers, coached patients’ disease self-management, and supported interactions with social services.
Duration: max 2 years
Add on: +
Control group: No intervention
Clinical effect:
- Risk of hospitalization: Site a → / Site b ↓
Patient safety: NA
Patient experiences: NA
Staff experiences: NA
Investment:
Staff resources
- Nurses were employed by a private entity (Health navigator.)
- Training nurses
Running:
Staff resources
- Nurses for interview and telephone call
Organization:
- Development of new skills (nurses)
Health care utilization:
- Total healthcare costs →
- Number of days in hospital →